A nasal spray could soon provide quick relief for people experiencing sudden, rapid heartbeats. This innovative treatment is being developed by researchers at Weill Cornell Medicine, New York-Presbyterian Hospital, and may eliminate the need for patients to seek urgent medical treatment at the start of their symptoms.
People with Paroxysmal supraventricular tachycardia (PSVT) experience sudden, rapid heart rate spikes due to extra electrical pathways connecting the upper and lower heart chambers. In PSVT, the heart's lower chambers briefly beat faster than 100 times per minute.
Though generally not life-threatening, this condition can significantly impact one's quality of life, manifesting itself in symptoms like fainting, light-headedness, shortness of breath, dizziness, and heart palpitations. It's important to note that this condition can emerge at any stage of life and may be connected to diverse underlying factors, such as anxiety, cardiomyopathy, and pneumonia.
As per the National Library of Medicine, this condition impacts a significant portion of the United States population, and is expected to affect nearly 7 million people by the year 2050.
Developing a safe and user-friendly first-line treatment for PSVT has been a longstanding objective in medical research. Presently, treatment options typically revolve around addressing the underlying causes of PSVT. This may involve prescribing beta blockers for cases linked to hyperthyroidism or utilizing surgical or catheter procedures to correct abnormal heart tissue.
In milder cases, doctors may employ vagal maneuvers, a set of techniques that includes applying abdominal pressure, executing "bearing down" motions, and gently manipulating the carotid artery to soothe the vagus nerve.
In the latest research, published in the Journal of the American Heart Association, the research team built upon a prior randomized, placebo-controlled clinical trial involving etripamil. Etripamil, administered in nasal spray form, functions as a calcium channel blocker, similar to intravenous medications administered in hospitals. This medicine prevents calcium from entering heart and artery cells, causing relaxation and dilatation and, as a result, slowing the heart rate.
The nasal spray, which is suitable for on-the-go use and can be stored at room temperature, can be self-administered by individuals when necessary. Each cartridge has two doses and it is advised to administer one shot into each nostril. If the first dose fails to lower the heart rate, the second dose can be administered, as per the researchers.
A study published in the journal Circulation: Arrhythmia and Electrophysiology last year concluded that self-administered etripamil is a reliable and efficient treatment option for PSVT episodes. Approximately 55 percent of patients successfully reverted to their normal heart rhythms within 30 minutes of taking etripamil, while only 35 percent experienced the same improvement with a placebo.
The most recent research examined how individuals would fare when using the drug in a practical setting, where they used it as needed, obtained refills, and reused it when their subsequent episodes occurred. Among the 169 participants who took part, 105 independently administered at least a single dose of etripamil over the study's duration, accounting for a combined total of 188 occurrences. Forty people were treated in two separate episodes.
Among these, etripamil successfully reinstated regular heart rhythms within 30 minutes in approximately 60% of cases and within an hour in roughly 75% of cases. In the group that administered it twice, 63% regained normal heart rhythms within 30 minutes. However, approximately 25% of these individuals did not respond to the medication during either episode.
While this study offers promise, it's important to recognize that more work, including subsequent research and eventual approval from the FDA, is necessary before this drug can be considered suitable for public use.
Currently, researchers are evaluating the nasal spray's effectiveness in treating children's heart ailments as well as other heart conditions, such as atrial fibrillation, which occurs when the upper chambers of the heart beat rapidly and irregularly.
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